NTA Level 6 • Semester 2 • PST06208

Introduction to Health Promotion

Pharmaceutical Public Health • Source Session/Topic 3

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Session 3: Introduction to Health Promotion

Total Session Time: 120 minutes

Prerequisites

• None

Learning Tasks

By the end of this session, students are expected to be able to:

• Define the terms health and health promotion

• Explain the goals, objectives and scope of health promotion

• Explain the principles of health promotion

• Identify health promotion strategies

• Explain health promotion approaches

Resources Needed

• Flip charts, marker pens, and masking tape

• Black/white board chalk and whiteboard markers

• LCD Projector and Computer

• Handout 3.1: Scope of Health Promotion

SESSION OVERVIEW

SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before continuing

STEP 2: Definition of the Terms Health and Health Promotion (10 minutes)

|Activity: Brainstorming (5 minutes) |

| |

|Ask students to brainstorm on the following question: |

|What is health promotion? |

| |

|ALLOW few students to respond |

| |

|WRITE their responses on the flip chart/ board |

| |

|CLARIFY and SUMMARISE by using the content below |

• Health:

o Is a state of complete physical, mental, and social well-being and

not merely the

absence of disease and infirmity

• Health Promotion:

o Health promotion is the process of enabling people to increase control

over the determinants of health and thereby improve their health

▪ Health promotion represents a comprehensive social and political

process

▪ It embraces actions directed at strengthening the skills and

capabilities of individuals

▪ It embraces action directed towards changing social, environmental

and economic conditions so as to alleviate their impact on public and

individual health

▪ Participation is essential to sustain health promotion action

▪ Some examples of health promotion activities include:

• Water and sanitation activities

• Nutrition program for a community

• Infection prevention activities such immunization

• Awareness campaign on HIV testing

STEP 3: Goals, Objectives and Scope of Health Promotion (30 minutes)

• Goal of health promotion:

o Health promotion aims to strengthen the skills and capabilities of

individuals and groups so that they can take actions to change social,

environmental, and economic conditions so as to improve individual and

public health

o Possible physical environments and economic conditions that can impact

health promotion efforts include:

▪ Peace

▪ Shelter

▪ Education

▪ Food

▪ Income

▪ Stable economic system

▪ Sustainable resources

▪ Social justice and equity

• Objectives of health promotion:

o Prevent disease (preventive and early medical treatment) and early

medical treatment,

aimed at preventing diseases before they occur and if they do occur,

identifying them

early and ensuring early treatment to prevent complications (primary

and secondary

prevention)

o Prevent complications of diseases by making sure that actions are

taken to prevent death and rehabilitate the person so that they are

able to do normal daily living activities

o Ensure that people are well-informed and able to make healthy choices

o Help people acquire the skills and confidence to take greater control

over their health

(education and empowerment) through behavior change communication

(BCC) or

information education and communication (IEC)

o Change policies and environments to facilitate healthy choices

(empowerment and social change that aims to promote individual’s

ability to make positive decisions about health).

• The Scope of Health Promotion

o The scope of health promotion is determined as much by expected health

outcomes as by methods and forms.

o From its purpose to enable people to gain greater control over the

determinants of their health, health promotion can be defined as any

combination of educational and

environmental supports for actions and conditions of living conducive

to health.

[pic]Refer students to Handout 3:1 for further reading

STEP 4: Principles of Health Promotion (25 minutes)

• Principles of Health Promotion (According to WHO):

o Equity in health

▪ Means that the needs of people should guide the distribution of

opportunities for wellbeing

▪ All people have equal opportunity to develop and maintain their

health through fair and just access to health resources

▪ WHO has a global strategy to achieve greater equity in health

between and within

populations and countries through health promotion initiatives that

is guided by a concern for equity and social justice

o Empowerment for health

▪ Health promotion initiatives should enable individuals and

communities to assume more power over the personal, socio-economical,

cultural, psychological or political processes through which they are

able to express their needs, present their concerns, devise strategies

for involvement in decision-making, and achieve political, social and

cultural action to meet those needs

o Participatory

▪ Health promotion initiatives should involve those concerned in all

stages of planning, implementation and evaluation

o Inter-sectoral

▪ Health promotion initiatives should involve the collaboration of

agencies from relevant factors

o Sustainable

▪ Health promotion initiatives should bring about changes that

individuals and

communities can maintain once initial funding has ended

o Multi-strategy

▪ Health promotion initiatives should use a variety of approaches,

including policy

development, organizational change, community development,

legislation, advocacy, education and communication in combination

with one another

o Holistic

▪ Health promotion initiatives should foster physical, mental, social

and spiritual health

STEP 5: Health Promotion Strategies and Approaches (40 minutes)

|Activity: Buzzing (5 minutes) |

| |

|ASK students to pair up and buzz on the following question for 2 |

|minutes |

| |

|What are health promotion strategies? |

| |

|ALLOW few pairs to respond and let other pairs to add on points not |

|mentioned |

| |

|WRITE their response on the flip chart/board |

| |

|CLARIFY and SUMMARIZE by using the content below |

• Health promotion strategies used in the implementation of health

promotion include:

o Enabling

▪ This means taking action in partnership with individuals or groups

to empower them through the mobilization of human and material

resources, to promote and protect their health

▪ Health promotion includes strengthening people’s health knowledge

and the skills

required to prevent ill health, enhance and protect healthy

behavior

▪ This is achieved through health education, IEC, and Social

mobilization interventions among individuals and communities

o Creating environments that are supportive of health

▪ Health promotion facilitates mediation in society through which the

different interests of individuals and communities and different

sectors, both public and private, are reconciled in ways that promote

and protect health.

▪ This is achieved through legal, economic and environmental policies

and legislation.

o Advocacy to create the essential conditions for health

▪ Advocacy for health implies a combination of individual and social

actions designed to gain political commitment, policy support, social

acceptance and systems support for a particular health programme

▪ Advocacy may be carried out through lobbying, social marketing and

community organizing, identify health promotion approaches and

strategies

• Health promotion approaches used in the implementation of health

promotion include:

o Preventive approach

▪ This approach aims to reduce premature deaths (mortality) and

avoidable diseases

(morbidity)

▪ It has three levels:

• Primary prevention: Prevention of disease onset, example:

immunizations

• Secondary prevention: Prevention of the progression of disease,

example: screening and other methods of early diagnosis and treatment

• Tertiary Prevention: Reducing further disability or preventing the

recurrence of illness

o Behavior change approach also known as the information giving model

▪ This approach aims to bring about change in individual behavior

through changes in individuals’ knowledge

▪ It is usually implemented through provision of information related

to health risks through the mass media, leaflets or posters

▪ In this approach health promotion is really synonymous with health

education that aims to increase individual’s knowledge about the

causes of health and illness

▪ An example is giving information to clients about the effects of

smoking and helping them to explore their own values and attitudes and

come to a decision

o Self-Empowerment Approach (Educational)

▪ The goal of this approach is to empower individuals to make healthy

choices.

▪ Self-empowerment can be defined as the process by which groups and

individuals increase their control over their physical, social and

internal environments.

▪ Education may lead to behavior change and health promotion. It seeks

to provide knowledge and information, and to develop the necessary

skills so that people can make informed decisions about their behavior

▪ It is strongly linked to health education

▪ In order to facilitate self-empowerment, participatory learning

techniques allow people to examine their own values and beliefs and

explore the extent to which factors such as past socialization and

social location affects the choices they make

• Examples of participatory learning include group work, counseling,

training, storytelling and educational drama

o Community development approach or social change approach

▪ This approach focuses on influencing health policy

▪ Aims to bring about physical, social, economic, political, and

environmental changes to promote or enhance health

▪ Improving the socio-economic environment through policy can improve

the health of the individual and community. In this, individuals

organize and act collectively in order to change their physical and

social environments

▪ The key characteristic of this approach is that it begins from the

experiences and perspectives of communities

▪ There is participatory planning through community needs assessment,

goal setting, resource planning and task allocation to as many

participants as possible

▪ The main benefits of this approach is improved networking in a

community, identification of health needs from the user’s point of

view, in particular the disadvantaged and socially excluded groups,

development of local services and structures that act as a resource

and improved self-esteem and learning of new skills

▪ Examples of the social change approach include national policies

like those that help the poor or provide equal access to free

medication and the ministry of health and social welfare (MOHSW’s)

goal to provide a dispensary in every village and ward

o The Ecological Approach

▪ View health as a product of the interdependence between the

individual and subsystems of the ecosystem (e.g. family, community,

culture, and the physical and social environment)

▪ To promote health, an ecosystem must offer economic and social

conditions conducive to health and healthful lifestyles

▪ These environments must also provide information and life skills

that enable individuals to engage in healthful behaviors

▪ Finally, healthful options among goods and services must be

available. In an ecological context, all such elements are viewed as

determinants of health. They also provide support in helping

individuals modify their behaviors and reduce their exposure to risk

factors

STEP 6: Key Points (5 minutes)

• Health promotion enables people to increase control and improve their

health

• Principles of health promotion include equity, empowerment,

participatory, holistic, sustainable, inter-sectoral and multi-

strategy

STEP 7: Evaluation (5 minutes)

• What is health promotion?

• What are the principles of health promotion?

• What are the strategies and approaches for health promotion?

References

Butler, J.T. (2001). Principles of Health Education and Health Promotion.

London: Wadsworth.

Downie, R.S. et al (1996). Health Promotion Models and values (2nd ed).

Great Britain: Oxford University Press.

Ewles, L. & Simnett, I. (2003). Promoting Health. A Practical Guide (5th

ed). London: Bailliere Tindal.

MOHSW (2001). Health Management Training Module Two: Promoting Partnership

in the

District-Second Version. Dar es Salaam, Tanzania: Ministry of Health and

Social Welfare.

WHO (1986). Ottawa Charter for Health Promotion. Geneva: World Health

Organization.

Wood, C.H. (2008). Community Health (3rd ed.). Nairobi: African Medical

and Research

Foundation (AMREF).

Wood, C.H. et al (1997) Community Health. (2nd ed.). Nairobi: African

Medical and

Research Foundation (AMREF).

Nutbeam, D. (1986). Health promotion glossary. Health Promotion

International,1(1), 113-127. doi:10.1093/heapro/1.1.113

Health Promotion International. (2011). Health Promotion International,

26(1), 129-131. doi:10.1093/heapro/dar010

Alma Ata, USSR. WHO, Geneva, (1978), Report of the international conference

on primary

health care

A call for Action/WHO/HEP/90. WHO, Geneva Promoting health in developing

countries:

1990.

World Health Organization (1997) Jakarta declaration on leading Health

Promotion into 21st century; Geneva: WHO

Handout 3.1: Scope of Health Promotion

• The Ottawa charter of 1986 established the core principles of health

promotion which seek to identify and positively affect the root

causes, or determinants of health. These are social and economic

factors that determine health status such as income, education,

profession, working conditions, mental status, which in turn can

affect risk factors such as smoking, alcohol consumption and poor

eating habits

• In health promotion it is essential to work with individuals, families

and communities. It is an active process for better health,

encompassing educational components; behavior change initiatives; and

environmental, organizational and legislative interventions

strategies. The process is described below:

o Focus strategies impact outcomes

▪ Change in health behavior is currently the most important

intervention solution to many of today’s pressing health and

disease problems such as teenage pregnancies, STIs and HIV/AIDS

infection, smoking and drug abuse

▪ The broad spectrum of health promotion has made it apparent that

all health workers together with other professionals must be

involved. They include teachers, agricultural extension workers,

community leaders (including church and women group leaders,

journalists and other media workers, and politicians.

o To bring about a change in health behavior:

▪ The individual, group or community should perceive the given health

problems as priorities.

▪ The health worker should understand the socio-economic, cultural and

psychological aspects of health problems in question and work with

individual or the community to find appropriate solutions, using

locally available resources.

• Other social conditions influenced by health promotion

• Health encompasses many factors at individual and community level,

including the

environment

• Health promotion not only encompasses actions directed at

strengthening the basic life skills and capacities of individuals, but

also at influencing the underlying social and economic conditions and

physical environments that impact health. In keeping with the concept

of health as a fundamental human right, the Ottawa Charter emphasizes

certain pre-requisites for health which include peace, adequate

economic resources, food and shelter, and a stable eco-system and

sustainable resource use

• Recognition of these pre-requisites highlights the important links

between social and economic conditions, the physical environment,

individual lifestyles and health

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